Application for Inclusion in the Empowerment Initiative’s Suppliers List
Required Format of Supplier Declaration

To:  The Empowerment Initiative and its labels/brands (the “Empowerment Initiative”)

Supplier legal name: [	] BR No. / Reg. No.: [    ]
Registered address: [__________]
Primary contact (name/title/email/phone): [		 / ______________ / ______________ / __________]
Goods/Services categories: [				]
Licences/permits/certifications: [		]
Authorised signatory(ies): [________________________________]

Declarations (tick ✓ each box)
1.	☐ Authority & accuracy. I/we are duly authorised to sign this Declaration on behalf of the Supplier. Information provided is true, accurate, and complete, and will be kept up-to-date without delay.
2.	☐ Compliance with law; no advantages. The Supplier will comply with all applicable laws. The Supplier will not offer, solicit, give or accept any advantage (including gifts or commissions) in connection with any quotation, tender, order or contract, and will ensure staff/agents do likewise.
3.	☐ No collusion / independent bidding. The Supplier will prepare and submit all quotations/tenders independently, and will not engage in bid-rigging or other serious anti-competitive conduct.
4.	☐ Conflicts of interest. The Supplier has no actual or potential conflict in relation to any invitation or award from the Empowerment Initiative unless disclosed in writing in advance. The Supplier will promptly disclose any conflict that arises.
5.	☐ Performance & licences. The Supplier will maintain all required licences/permits and comply with the relevant standards for the goods/services offered; it will perform any awarded order/contract on time, to specification, and with adequate after-sales support.
6.	☐ Procurement communications (consent). The Supplier consents to the Empowerment Initiative sending procurement-related invitations/notices to the authorised contacts by email or other electronic means. Each message may include sender identification and an unsubscribe facility; the Supplier may opt-out at any time for future messages.
7.	☐ Personal data notice. Personal data supplied will be used for supplier due diligence and procurement administration and may be shared with the Empowerment Initiative’s labels/brands and service providers for these purposes. Authorised contacts may access/correct their personal data by writing to admin@empowerment.hk. The Supplier acknowledges this notice.
8.	☐ E-signatures. The Supplier agrees that this Declaration and related documents may be executed electronically, and such execution is intended to be legally effective.
9.	☐ No entitlement / limited liability. The Supplier acknowledges that inclusion in the pre-qualified list does not create any right or expectation to receive invitations or awards. To the extent permitted by law, the Empowerment Initiative disclaims liability for any loss from delayed/failed transmission of invitations or from suspension/removal from the list, save for liability that cannot lawfully be excluded.
10.	☐ Governing law: The Supplier agrees to surrender to the exclusive jurisdiction of the courts and tribunals in accordance with the laws and regulations of the Hong Kong SAR over the interpretation and dispute resolution of matters between you and the Empowerment Initiative..
On behalf of the Supplier:
Name: _________________________ Title: _________________________
Signature: _____________________ Date:       /       /  20____ 		Company chop (if any)

Optional disclosure attachments (if applicable):
A. Conflict-of-interest disclosure ☐ Yes (attached) ☐ N/A
B. Sub-contracting / consortium arrangements ☐ Yes (attached) ☐ N/A
C. Licences/permits/certificates list ☐ Attached